This is the perfect medical editorial - taking a simple and oft-repeated widespread medical folk hypothesis and placing it in the broader context and then going beyond that to expound on the dangers of biases that should be eradicated in medicine and society in general.
Myth: "African-Americans today are afflicted by hypertension at higher rate than whites because of genes passed on by their ancestors, genes that favored salt retention and that, in turn, cause high blood pressure... [slaves were] subjected to limited water and salt supplies and bouts of dehydration. As a result, a genetic predisposition for salt retention evolved in individuals of African descent. A higher sodium-retention mechanism enhanced survival during these extreme weather conditions, but the same mechanism would lead to hypertension..."
"However, pathophysiological, historical, and anthropological data strongly dispute the hypothesis... the results of sodium balance studies... consistently demonstrate that, in response to salt loading, normal salt-resistant subjects (individuals resistant to the pressor effects of salt) retain just as much sodium as salt-sensitive subjects (individuals with a pressor response to salt). Despite retaining just as much salt as salt-sensitive subjects, salt-resistant subjects do not develop hypertension...even if African-Americans were genetically programmed to conserve more salt (which is highly unlikely), this alone would not elevate their blood pressure. "
"even if African-Americans were genetically programmed to conserve more salt (which is highly unlikely), this alone would not elevate their blood pressure... It is not possible to categorize an entire racial group as being genetically or physiologically distinct from one another because of the vast genetic heterogeneity of our populations."
"Overcoming this bias and refusing to treat African-Americans as a genetically homogenous group is critical for our nation's health because minorities receive less and lower quality healthcare than do Caucasians...we should reject the premise of genetic determinism and essential black abnormality and not think of racial groups as fundamentally distinct in terms of biology or physiology."
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